What is the difference between the Ozempic pill and Mounjaro?

When it comes to medications for managing type 2 diabetes, you have options — two of which are the Ozempic pill and Mounjaro, which is an injection. Yes, they have a lot of similarities, but there are some key differences as well. Keep reading to learn more about the Ozempic pill versus Mounjaro, including how each works, effectiveness, side effects, and more. With this information (and the guidance of a healthcare practitioner) you'll be well-equipped to make an educated decision about what is best for you.

The Ozempic pill is an oral version of semaglutide, which belongs to a class of drugs called glucagon-like peptide 1 receptor agonists (GLP-1s). Taken as a pill once daily, it’s designed to help adults with type 2 diabetes regulate their blood sugar levels. By mimicking the naturally occurring GLP-1 you have in your body, the Ozempic pill stimulates the release of insulin when blood sugar is high and decreases the release of sugar from the liver, two actions that help regulate your blood sugar. It also helps reduce your appetite and slows the emptying of food from your stomach, so you stay full for longer, potentially leading to weight loss. It can lower the risk of major cardiovascular events, such as stroke, heart attack, or death, in adults with type 2 diabetes who are also at high risk for these events.

Mounjaro is the brand name of tirzepatide, which is also FDA approved for controlling blood sugar in adults with type 2 diabetes. It’s a once-weekly injection that works by mimicking two hormones in your body: GLP-1 and glucose-dependent insulinotropic polypeptide (GIP). These two hormones work together — the GIP amplifies the impact of the GLP-1 — to help your body bring down blood sugar (by releasing insulin), reduce appetite, and slow down digestion. The result is improved glucose control and, similar to the Ozempic pill, some weight loss, though these are not approved as weight loss medications.

The two main differences between Mounjaro and the Ozempic pill are their active ingredients and the way they’re administered. The Ozempic pill is oral semaglutide, while Mounjaro is injectable tirzepatide. Additionally, the two medications aren’t taken with the same frequency: the Ozempic pill is once a day orally and Mounjaro is once a week as an injection.

Ozempic pill and Mounjaro are both FDA-approved for the treatment of type 2 diabetes in adults aged 18 and over. They help control blood sugar by mimicking naturally occurring hormones in your body: the Ozempic pill mimics GLP-1, while Mounjaro mimics GLP-1 and GIP. These medications improve insulin production, slow digestion, reduce blood sugar release from the liver, and decrease appetite.

There is an injectable form of Ozempic as well. And both semaglutide and tirzepatide (the active ingredient in Mounjaro) have brands FDA-approved for weight loss: Wegovy (semaglutide) and Zepbound (tirzepatide).

GLP-1 medications like Mounjaro and the Ozempic pill follow what’s known as a slow titration method when someone is first starting out on them. This means doses start small and increase slowly to allow the body to gradually adjust to the medication and minimize side effects.

The Ozempic pill is a once-daily pill that is taken by mouth. The starting dose for the Ozempic pill is generally 1.5 mg daily for 30 days, increasing to 4 mg daily for 30 days and, if necessary, going up to the maximum dosage of 9 mg daily. There are some “rules” around how to take the Ozempic pill —  it is recommended to take the pill in the morning on an empty stomach with a sip of 4 oz water at least 30 minutes before eating and do not crush, chew or double up on missed pills— that your prescriber will be able to go over with you.

Mounjaro is a once-weekly injection that can be administered into the thigh, abdomen, or upper arm. Mounjaro starts at 2.5mg once weekly for the first 4 weeks, and is then slowly increased by 2.5mg every 4 weeks until your doctor is happy with your glucose control or you hit the maximum Mounjaro dosage of 15mg. You can do the injection at any point in the day, but it can help to give it to yourself at the same time each week so that you don’t forget.

Both the Ozempic pill and Mounjaro are effective at reducing A1c levels, which is a way to measure blood sugar over time. Research has shown that after six months, people on the Ozempic pill reduced their A1c by an average of 1.2%-1.4%.

Mounjaro has slightly better results. After nine months, patients on a 10mg Mounjaro prescription reduced their A1c by 1.9, and those taking 15mg of it reduced their A1c by 2.1%. Keep in mind, though, that the effectiveness of any medication is truly dependent on the individual — one person might react better to the Ozempic pill while another to Mounjaro.

While glycemic control is the intended use of these medications, weight loss is often a common side effect. People on 15mg of Mounjaro could lose an average of 20.9% of their body weight in a little more than a year while the Ozempic pill has less effect on weight loss, potential annual loss of approximately 14%.

If you have health insurance, you can pay as little as $25 for up to a 3-month prescription for the Ozempic pill, according to the manufacturer Novo Nordisk. If your healthcare provider prescribes the Ozempic pill or Mounjaro for its intended use of managing type 2 diabetes and you have health insurance, it’s likely to cover a large portion of the medication cost as long as you meet any prerequisites. However, if your provider prescribes either medication for weight loss, you may have to pay out of pocket as insurance companies are less likely to cover the cost of Mounjaro or the Ozempic pill when used off-label.

The Ozempic pill and Mounjaro can be pretty expensive if you don’t have insurance. According to Eli Lilly, which manufactures Mounjaro, the list price (the original price set for a medication by a manufacturer before any discounts are applied) of Mounjaro is $1,079.77 per month. The retail price for the Ozempic pill that’s approved for type 2 diabetes ranges from $149 to $299 per month for uninsured or self-pay, depending on if you’re a new patient and what dose you’re taking.

Keep in mind as well that there may be manufacturer’s savings programs that can help bring down your out-of-pocket cost. You can find information on these for the Ozempic pill here and Mounjaro here.

While these medications can have significant effects on your blood sugar control and ability to lose weight, they may cause uncomfortable side effects — especially when first starting on the medication or increasing the dosage. The common side effects tend to be gastrointestinal, like nausea and diarrhea, and can be made worse by certain behaviors: eating rapidly, consuming large meals, or fatty, greasy foods can exacerbate these symptoms. Since making certain changes to your diet can help manage these side effects, pairing these medications with a lifestyle program like Weight Watchers, which includes access to registered dietitians, can be helpful.

The Ozempic pill side effects

The most common side effects of the Ozempic pill include stomach pain, nausea, diarrhea, vomiting, constipation, and decreased appetite. Other serious side effects to be aware of include pancreatitis, changes in vision, low blood sugar (when combined with other diabetes medications), kidney problems, severe stomach problems, allergic reactions, and gallbladder problems. Find a full list of the Ozempic pill side effects here.

Mounjaro side effects

Common side effects of Mounjaro are similar to those of Ozempic. They include nausea, diarrhea, decreased appetite, vomiting, constipation, indigestion, and stomach pain.Generally Mounjaro may have less side effects than Ozempic pill. More rare but serious side effects include kidney problems, severe stomach problems, pancreatitis, low blood sugar (when combined with other diabetes medications), allergic reactions, changes in vision, and gallbladder problems. You can see the full list of Mounjaro’s side effects here.

While generally considered safe medications, both the Ozempic pill and Mounjaro feature the same black-box warning (the FDA’s most serious warning label) of a risk of thyroid C-cell tumors, including medullary thyroid carcinoma (MTC). While that sounds scary, the warning is based on rat studies, and there haven’t been any studies determining the risk in humans. They should also not be used in patients with a personal or family history of MTC or who have multiple endocrine neoplasia syndrome type 2 (MEN 2).

There are also the more serious side effects noted above. In rare cases, each [medication] carries the risk of gallbladder issues, pancreatitis, exaggerated gastroparesis, bowel obstruction, and mood changes. Semaglutide may also have an increased risk of non-arteritic anterior ischemic optic neuropathy (NAION), which is an optic nerve disorder that can cause significant vision issues. That said, the risk that any of these occur are quite low and has not been proven yet in other studies. For context, less than 1% of patients in the placebo-controlled clinical trials for each drug reported gallbladder issues.

The Ozempic pill and Mounjaro are both GLP-1 agonists FDA-approved to treat type 2 diabetes in adults, but they have some key differences. The Ozempic pill (semaglutide) is a daily oral weight-loss medication that contains only GLP-1 hormone, whereas Mounjaro (tirzepatide) is a once-weekly injection featuring GLP-1 and GIP hormones. The Ozempic pill and Mounjaro both have similar side effects, which tend to impact the gastrointestinal system. Research suggests that both medications promote blood sugar control and weight loss; however, Mounjaro may produce more significant results and less overall side effects.